Psychiatric Medical Malpractice Claim Dismissed
A psychiatrist who misjudged a patient’s risk of suicide was found not to have been negligent when the patient subsequently committed suicide.
In Buyze v. Malla the deceased, Mr. Buyze had been treated several times by various doctors for depression and suicidal thoughts. He was seen in the emergency department by the on-call psychiatrist, the Defendant Dr. Malla who diagnosed him with:
…major depression with anxiety and a history of suicidal ideation…
Buyze was admitted to the psychiatric ward of the Hospital. He subsequently left the Hospital ward and was later found to have comitted suicide by over dosing. After Mr. Buyze’s body was found, the Defendant Malla added the words “no attempts/no plans.” to his diagnosis of Mr. Buyze.
The trial judge ruled that:
…history has proved that Dr. Malla erred in his assessment of Mr. Buyze’s risk of suicide. I am not persuaded, however, that Dr. Malla breached the standard of care expected of a reasonably prudent psychiatrist.
The court stressed that an error of judgement is not necessarily negligence and that the court must be careful not to judge an individual’s conduct on the basis of consequence alone.
The court quoted a decision from the New York Court of Appeal in Fiederlein v. City of New York Health and Hospitals Corporation where the American Court said:
The prediction of the future course of a mental illness is a professional judgment of high responsibility and in some instances it involves a measure of calculated risk. If liability were imposed on the physician…each time the prediction of future course of mental disease was wrong, few releases would ever be made and the hope of recovery and rehabilitation of a vast number of patients would be impeded and frustrated. This is one of the medical and public risks which must be taken on balance, even though it may sometimes result in injury to the patient or others.
The Buyze decision highlights the difficulty of psychiatric malpractice claims. In most medical negligence claims the expected outcome of a case can be accurately predicted on the basis of accepted scientific and medical evidence.
However, in psychiatric cases the outcome often involves not only considering the scientific and medical evidence, but the vagaries of human behavior. The courts are loathe to hold doctors responsible for failing to forsee the inherently unpredictable behavior of psychiatric patients.
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